Cortisol dysregulation in school teachers in relation to burnout, vital exhaustion, and effort-reward-imbalance.

We analyzed whether burnout and vital exhaustion or job-related chronic stress is associated with hypothalamic-pituitary-adrenal (HPA) axis dysregulation in school teachers (N=135; 25-63 years; mean age 46.1+/-9.20 years). Participants collected seven saliva samples (0, 30, 45, and 60 min after awakening, 11a.m., 3 p.m., 8 p.m.) on 2 working days, 1 leisure day, and after pre-medication with 0.25mg dexamethasone (very low-dose dexamethasone suppression test) to assess basal cortisol day profiles and HPA axis negative feedback sensitivity. No associations were found between basal cortisol activity and burnout (Maslach burnout inventory, teacher burnout scale), vital exhaustion (Appels vital exhaustion questionnaire), or any component of Siegrist's effort-reward-imbalance model. However, after dexamethasone higher burnout and vital exhaustion and lower reward were significantly related to stronger cortisol suppression, pointing to altered HPA axis negative feedback sensitivity. Though, all teachers were working and in a good health status, burnout/exhaustion as well as facets of the ERI model appear to be associated with subtle dysregulation, manifested as heightened HPA axis negative feedback although not in basal cortisol day profiles.